Epidural Steroid Injection (Nerve Block)
If other treatments do not relieve your neck pain, you may be given an epidural steroid injection (ESI), also called a nerve block. An ESI places a small amount of cortisone into the bony spinal canal. Cortisone is a strong anti-inflammatory medicine that may control the inflammation surrounding the nerves and may ease the pain caused by irritated nerve roots. This injection is often used when other conservative measures do not work, or in an effort to postpone surgery. This treatment is not always successful but may provide short-term help. Learn more about spinal injections.
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If your condition is causing only mild symptoms and does not appear to be getting worse, your doctor may have you work with a physical therapist. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.
In mild cases, nonsurgical treatments offer ways to control symptoms and enable you to improve without surgery. You may be issued a neck brace to hold your neck steady, reducing extra strain. You will need to limit your activities, especially heavy and repeated movements of the arms and neck. Therapists use electrical stimulation to ease muscle spasm and pain. Treatments may also include cervical traction to gently stretch the joints and muscles in the neck. Therapy sessions may be scheduled two to three times each week for up to six weeks.
The goals of physical therapy are to help you
- learn correct posture and body movements to minimize the effects of stenosis
- maintain appropriate activity levels
- identify symptoms of stenosis that require medical attention
- learn ways to manage your condition
Cervical myelopathy can be a serious problem. The pressure on the spinal cord usually will not go away without surgery, and the symptoms may continue to get worse. If you do not improve with non-operative care, your doctor may suggest surgery.
There are several surgical procedures used to treat cervical spinal stenosis that is causing cervical myelopathy; all have the same goal-to relieve the pressure on the spinal cord by making the spinal canal larger.
Your surgeon may suggest an operation called a laminectomy, in which the backside of the vertebrae is opened to allow more room for the spinal cord. Discectomy, the removal of one or more discs, may be suggested if stenosis is coming from problems of disc herniation. This surgery may be done from the front or back of the spine. Or your surgeon may suggest an operation that is done from the front of the neck-a corpectomy and strut graft. This operation involves removing the discs and vertebral bodies in the area where problems are occurring. Bone spurs that are pushing into the spinal cord are also removed. The vertebrae are then replaced with a solid piece of bone graft (called a strut graft). The strut graft heals over time to create a solid fusion of the spine where the vertebral bodies have been removed.